Lymphatic System Flashcards

1
Q

What is the key function of the lymphatic system?

A

Immune defense and transport and drainage of excess fluids, proteins, cellular debris from interstitial spaces

plays a role in maintaining homeostasis

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2
Q

What kind of system is the lymphatic?

A

“drainage or sanitation” system

one-way system designed to transport lymph through a system of deep/superficial vessels and lymph nodes

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3
Q

What does the lymphatic system include?

A
  • nodes
  • thymus
  • bone marrow
  • spleen
  • tonsils
  • Peyer patches of small intestine
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4
Q

What is the normal functions of lympathic system?

A
  • remove waste products
  • remove excess fluid
  • alert the immune system
  • return fluid and plasma proteins to the blood
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5
Q

What is transport capacity?

A

Amount of fluid the system can move when working at max intensity

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6
Q

Under normal conditions, what percentage does transport capacity work at?

A

~ 10% of normal capacity

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7
Q

What is functional reserve?

A

The difference between the TC and amount of fluid that is being transported at rest

known as the “lymphatic load” (LL)

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8
Q

What are the causes of lympathic system insufficiency?

A
  • Dynamic
  • Mechanical
  • Combined
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9
Q

What is dynamic insufficiency?

A

literally anything that needs the LL to work harder

Ex: ankle sprains

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10
Q

What is mechanical insufficiency?

A

Damage to the lympathic system = unable to handle the increased LL

  • anything that reduces the transport capacity = lower ability to get fluid out

Ex: surgery, infection or trauma

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11
Q

When does lymphedma develop?

A

When the TC drops below the LL amount = fluid build up in subcutaneous tissue

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12
Q

Lymphedema

high protein causes what?

A

Fibrosis and sclerosis of the tissues and increases risk of infection
- progressive disorder if left untreated

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13
Q

Lymphedema

What is the primary diagnosis?

A

Caused from abnormally developed lymphatic system (congential)

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14
Q

Lymphedema

What is the secondary diagnosis?

A

Caused from known injury to the system

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15
Q

Lymphedema

What are the risk factors?

A
  • excess weight increases the risk
  • significant factors for developing lymphedema which includes arm infection/injury
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16
Q

Lymphedema

What are the clinical presentations?

A
  • slow progression
  • mild warmth
  • rarely see color changes
  • usually, painless
  • sensation of fullness or heaviness in the limb
  • pitting edema or hard to palpate
  • asymmetrical comparison of limbs
17
Q

Differential dx

Lymphedema is has a ____ stemmer sign

A

positive

18
Q

Differential dx

General edema has ____ stemmer sign

A

Negative

19
Q

Differential dx

What are the signs and sx of lymphedema?

A
  • pitting edema
  • underlying fibrosis of skin
  • tight and heavy limb
  • decreased mobility or loss of ROM
  • tingling or numbness in surrounding joints
  • skin discolorations
  • common fungal discolorations
  • hardening of the skin
  • odor
  • wounds
  • decreased QOL
20
Q

Differential dx

What are the signs and sx of acute edema?

A
  • rapid onset
  • red
  • warmth
  • painful to palpate or movement
  • localized
21
Q

Differential dx

What are the signs and sx of chronic edema?

A
  • skin changes (hair loss)
  • loss of tissue elasticity or skin creases
  • moderate warmth
  • hemosiderin staining
  • achy pain progressive through the day
  • loss of normal contour in extermity
22
Q

Lymphedema Stages

Stage 0 characteristics

Latency

A
  • no clinical edema
  • negative stemmer sign
  • tissue and skin appear normal
  • lymph transport capacity already reduced
23
Q

Lymphedema Stages

Stage 1 characteristics

Reversible

A
  • edema preesent (soft and pitting)
  • edema reversible with elevation
  • edema increases with standing and activity
  • negative stemmer sign
  • normal tissue
24
Q

Lymphedema Stages

Stage 2 characteristics

Spontaneously irreversible stage

A
  • edema present
  • initially may still be soft and pitting in early stage 2 but progresses to nonpitting “brawny” edema
  • edema does not reverse with elevation
  • positive stemmer sign
  • tissue looks fibrosclerotic; proliferation of adipose tissue
  • frequent infections
  • skin changes
25
Q

Lymphedema Stages

Stage 3 characteristic

A
  • edema present
  • severe “brawny” nonpitting edema
  • edeema does not reverse with elevation
  • positive stemmer sign
  • tissue looks fibrosclerotic
  • proliferation of adipose tissue
  • frequent infections
  • skin changes
26
Q

What is the treatment of lymphedema?

A
  • dependent on the TYPE
  • primary is treated conservatively
  • secondary needs treatment of the cause first then proceed to conservative treatment
27
Q

What happens when lymphedema is left untreated?

A

Can lead to an increased risk of cellulitis

28
Q

What are the medication management for lymphedema?

A

edema management
or
primary disease exacerbations

29
Q

What are the causes of cellulitis?

A

infection of the skin caused by bacteria

30
Q

Cellulitis

When does it commonly occur?

A

when the integumetary system has an open wound for bacteria to get into
- strep/staph

31
Q

Cellulitis

What is the symptoms?

A
  • redness
  • edema
  • tenderness
  • pain
  • warm skin
  • blisters
  • fever
  • headaches
  • chills
  • weakness
  • red streaks
32
Q

Cellulitis

When does it become a medical emergency?

A

if the area spreads and becomes large
- skin changes colors (red to black)
- affects the face
- weakened immune system

33
Q

Cellulitis

How is it diagnosed?

A

Blood test
skin culture

34
Q

Cellulitis

What is the treatment?

A
  • antibiotics
  • topical antibiotics
  • wound dressing
  • pain meds PRN
  • surgery
35
Q

Cellulitis

What are the complications?

A
  • extensive tissue damage
  • gangrene
  • infection could spread to blood or other systems

could lead to sepsis, amputation, shock or death

36
Q

Cellulitis

What is the prevention?

A
  • hygiene
  • protecting dry skin
  • protective footwear
  • wound prevention